Factors Associated with Hospital Readmission in a Population with a Diagnosis of Personality Disorder

Abstract

Background: Hospital readmissions of users with personality disorders are frequent and represent a high personal and economic cost for health systems. This study aimed to identify risk factors associated with readmission in this population, examining sociodemographic and clinical variables. 

Methods: A retrospective observational study was conducted, using electronic records. The study was carried out at the Mental Health Hospitalization Unit of the Regional University Hospital of Málaga, covering all admissions between January 1, 2007, and March 31, 2024. Patients with a primary or secondary International Classification of Diseases, 10th Edition (ICD-10) personality disorder diagnosis were included. The dependent variable was hospital readmission, analyzed both at 30 days and at 1 year. Mixed logistic regression models were used to identify risk factors. 

Results: A total of 2403 admissions of 1072 individuals for 30-day readmission and 2256 admissions of 1029 individuals for 1-year readmission were analyzed; 17.15% of the admissions resulted in readmission at 30 days, and 42.33% at 1 year. The variables significantly associated with early readmission in the multivariate analysis were younger age (odds ratio (OR) = 0.973, p < 0.001), having a history of previous admissions (OR = 1.900, p < 0.001), and voluntary admission (OR = 1.348, p = 0.033). For readmission at 1 year, the significant variables included younger age (OR = 0.973, p < 0.001), history of previous admissions (OR = 1.956, p < 0.001), having another type of personality disorder diagnosis other than emotionally unstable personality disorder (OR = 0.654, p = 0.006), and comorbidity with affective (OR = 1.726, p = 0.025) and anxiety (OR = 1.915, p = 0.034) disorders compared to no comorbidity. 

Conclusions: This study identified key risk factors for hospital readmission of individuals with personality disorders, including younger age, previous admissions, voluntary admission, specific personality disorder types, and comorbidity with affective and anxiety disorders. These findings underscore the need for future research to better understand the risk factors for readmission in this population.